Achieving Ancillary Care Synergy Begins with Partnership

Creating a holistic care and treatment plan for an injured worker requires more than primary care. Additional ancillary care services are necessary to support full recovery. These services, ranging from physical therapy, diagnostic imaging, and at-home health care, are essential for treating, comprising 30% of total workers’ compensation medical spend.

For adjusters, managing a single worker’s ancillary care plan requires balancing appointment scheduling, transportation coordination, medical records requests, and treatment authorizations while ensuring both speed and quality of service. Handling this process for multiple injured workers can quickly become a complex and intricate task.

However, with an ancillary care partner, the process of coordinating comprehensive care plans can become streamlined and more cost-effective, empowering busy adjusters to focus on the direct worker interactions that matter most.

In CorVel’s recent webinar, our experts examined the benefits of an ancillary care partner in driving overall managed care success. Let’s dive into the details!

What is Ancillary Care Management? Is it Right for My Program?

Ancillary care management solves critical pain points, including patient uncertainty, provider challenges, and treatment overutilization, that often stem from fragmented workflows and communication silos. This is achieved by prioritizing integration. At its core, ancillary care management centralizes all aspects of managed care, including appointment scheduling, medical bill review, PPO networks, clinical utilization as well as those pertinent to physical medicine, imaging, medical equipment, and more.

Ancillary Care Providers Address Top Priorities

In industry surveys, employers and carriers spotlight key factors as top priorities for ancillary programs. Ancillary care providers address these objectives in the following ways:

• Optimized Savings: Cost-effective programs achieve both utilization and unit cost savings. Employing a patient-centric approach helps ensure that all treatment is return-to-work aligned, while utilizing discounted, in-network providers and engaging in a rigorous medical bill review that goes one step further to optimize service costs.
• Quality of Treatment: Quality care is critical to enhanced outcomes, and reducing utilization is only the first step. When ancillary care providers employ active clinical review and prospective care coordination, injured workers receive medically appropriate treatment without delay. These interventions support high-quality, outcomes-driven ancillary care programs.
• Customer Service: For injured workers, providers, and claims professionals alike, the call center is often the first point of contact in managed care services. CorVel’s Ancillary call center sets the standard for excellent customer service, with an average wait time of just two seconds. This efficient response time ensures a smooth experience, allowing for quick access to Intake Specialists and swift appointment scheduling, making a positive first impression every time

Strategies for Superior Outcomes

With the above program objectives as a guiding star, dedicated Ancillary Care Solutions transform goals into results. These interventions are marked by comprehensive care coordination, personalized treatment plans, and a preferred network of credentialed providers. Executing these solutions requires the following strategies:

1. Outline an Achievable Goal: Within the complex care process, restoring an employee’s ability to return to work can be overshadowed by secondary objectives. To avoid this pitfall, stakeholders need to set clear recovery goals that ensure employees can meet the physical demands of their jobs. Providers that specialize in work-related recovery are critical assets in this endeavor. These providers are adept at developing treatment plans that meet an employer’s functional job requirements, performing Functional Capacity Evaluations (FCE) for comprehensive determinations, and, in complex cases, initiating work rehab to enhance readiness.
2. Optimize Care Outcomes: Every case presents unique challenges, and CorVel addresses these through a flag system that identifies physical, psychological, and social obstacles, enabling prompt action. Treatment is aligned with evidence-based standards to ensure best practices and compliance with state-level requirements. CorVel’s licensed therapists regularly review therapy-related return-to-work literature, identifying when care is misaligned with best practices. Each Plan of Care is thoroughly reviewed to ensure it meets CorVel’s Standards of Care, which include treatment focused on the compensable injury, documentation of functional job demands, RTW/discharge goals tied to job demands, and injured worker buy-in. Therapists review each case every six visits or two weeks to track progress and, if needed, collaborate with treating therapists to guide treatment and documentation. To avoid exacerbating injuries, CorVel ensures that the right treatment is delivered at the right time, advocating for effective progression throughout care to support optimal recovery.
3. Track and Analyze Progress: Regular reporting on therapy and treatment progress enables consistent evaluation of results. When adjusters leverage end-to-end claims technology to provide real-time updates, track integral measures, and make critical risk assessments, stakeholders can more accurately assess recovery progress and better tailor programs to employees’ work-related goals.

Next Steps

Research indicates that the window of opportunity to positively impact claims outcomes is shrinking. According to WCRI, beginning physical therapy within three days of an injury results in an average temporary disability duration of seven weeks, whereas delaying therapy by up to thirty days extends this to fourteen weeks. Early action saves both time and costs, ensuring faster recovery and return-to-work.

CorVel’s Ancillary Care Program combines speed and efficiency to transform time-consuming administrative tasks into a seamless, unified system. By streamlining ancillary care coordination—from intake to appointment scheduling—CorVel makes the entire process more efficient, ensuring quicker and smoother service for all involved.

Discover how CorVel is driving 40% fewer physical therapy visits than the industry average while achieving a 43% savings rate per claim at www.corvel.com/services/workers-compensation/ancillary-care-solutions/.